Eliquis

Apixaban

Apixaban, an FDA-approved oral anticoagulant, is effective in preventing and treating conditions like atrial fibrillation, deep vein thrombosis, and pulmonary embolism. Available in two doses of 2.5 mg and 5 mg tablets, it works by inhibiting factor Xa to reduce blood clot formation. The typical dosage is 5 mg twice daily for stroke risk reduction and 2.5 mg twice daily for preventing recurrent blood clots. It’s important to take Apixaban consistently at the same time each day, with or without food. Common side effects are tiredness, dizziness, and nausea, while severe reactions may involve unusual bleeding or chest pain. Storage should be at room temperature, away from heat and moisture, and it’s essential to seek immediate medical attention to ensure there are not any severe side effects or symptoms of bleeding.

Product Overview

Apixaban is a potent anticoagulant medication primarily used to prevent and treat conditions such as atrial fibrillation,  pulmonary embolism (PE), and deep vein thrombosis (DVT) to reduce the risk of stroke. It is an FDA-approved oral tablet that is available in two dosage strengths of 2.5 mg and 5 mg. Apixaban works by inhibiting factor Xa, a key enzyme in the coagulation cascade, thereby reducing the formation of blood clots. It is commonly prescribed for patients with atrial fibrillation to lower the risk of stroke and for those who have had hip or knee surgery to prevent post-surgical clot formation.

Apixaban is typically administered twice daily, with or without food, and should be taken at the same time each day for consistency. The dosage is prescribed based on the condition being treated, with a usual dose of 5 mg twice daily for stroke risk reduction in atrial fibrillation and 2.5 mg twice daily for preventing recurrent DVT and PE. It is vital to stick to the recommended dosage and not to discontinue taking Apixaban without consulting a healthcare provider, as sudden discontinuation can increase the chances of blood clot formation or stroke.

Common side effects of Apixaban include tiredness, dizziness, and nausea, while severe side effects may involve unusual bleeding, chest pain, and allergic reactions. Patients should be cautious of interactions with other medications, especially blood thinners, NSAIDs, and certain antidepressants, which can increase the risk of bleeding. If you have any doubts, consult your doctor.

Uses

Targeted Treatment 

• Atrial Fibrillation
• Deep Vein Thrombosis
• Stroke Risk Reduction
• Pulmonary Embolism

Benefits

• Lowers the risk of stroke
• Prevents a type of blood clot called DVT (deep vein thrombosis)
• Lowers the risk of recurrent DVT or PE
• Prevents post-surgery clot formation

[Note: Do not take Apixaban without consulting your doctor. They will determine whether you need this medication based on your conditions.]

Apixaban Dosage

Forms & Strengths

Form: Oral tablet

Strength: 2.5 mg, 5 mg

Recommended Dosages

For Reducing Stroke and Clot Risks in AFib

5 mg, twice daily

For Preventing Recurrent DVT and PE

2.5 mg, twice daily. Treatment with Eliquis (Apixaban) usually begins after at least 6 months of initial blood clot treatment.

For Preventing DVT After Hip or Knee Surgery

2.5 mg, twice daily, starting within 24 hours post-surgery. The duration of treatment typically ranges from 2 weeks to a month, depending on the surgery type.

For Treating DVT and PE

Initially, the dose is typically 10 mg taken orally twice daily for one week, followed by a maintenance dose of 5 mg consumed orally twice daily.

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

How to Take It?

• Take Apixaban tablets twice a day.
• Aim for the same time each day.
• Swallow the tablet with a drink of water.
• You can take Apixaban with or without food.
• If needed, you can crush the tablets and mix them with water, apple juice, or apple purée. Swallow the mixture immediately.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Metformin Work?

Metformin enhances the body’s responsiveness to insulin, a hormone that regulates blood sugar levels. It reduces the amount of glucose secreted by the liver and boosts the uptake of glucose by muscle cells. This action helps mitigate blood sugar levels and controls glucose in people with type 2 diabetes, making it a commonly prescribed medication for managing the condition.

Important Safety Information

Side Effects

Common side effects of Metformin may include: 

• Tiredness and lack of energy
• Feeling dizzy or light-headed
• A mild rash
• Nausea

Adverse/Serious side effects of Metformin may include:

• Swelling or redness in the affected limb
• Confusion
• Difficulty speaking or understanding speech
• Dizziness
• Balance problems
• Skin that feels warm to the touch
• Difficulty breathing
• Chest pain
• Coughing
• Irregular heartbeat
• Feeling faint or lightheaded
• Dizziness
• Vomiting blood
• Bloody or dark-coloured stools
• Severe stomach pain or discomfort
• Pain
• Inability to urinate
• Tingling or burning sensation
• Numbness
• Weakness
• Sudden numbness or weakness on one side of the body

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Warnings

• Apixaban can significantly increase the risk of severe or fatal bleeding. Inform your doctor about all medications you are currently taking, including over-the-counter ones. Seek immediate medical assistance if you observe symptoms of bleeding, such as:
  • Easy bruising
  • Unusual bleeding
  • Unexpected pain or swelling
  • Feeling very weak or dizzy
  • Bleeding gums or nosebleeds
  • Heavy menstrual bleeding
  • Blood in your urine or stool
  • Any bleeding that will not stop
• Do not stop taking Apixaban without your doctor’s advice, as stopping suddenly can increase the risk of blood clots or stroke.

Precautions

• Do not take Apixaban if you are allergic to it or have active bleeding from surgery, injury, or another cause.
• Apixaban may increase your bleeding risk, especially if you have an inherited or disease-related bleeding disorder.
• Inform your doctor if you have an artificial heart valve or a history of bleeding problems, antiphospholipid syndrome with a triple-positive antibody test, or liver or kidney disease.
• Apixaban can cause a serious blood clot around the spinal cord during a spinal tap or spinal anesthesia, potentially leading to long-term paralysis. The risk is higher if:
  • You have or recently had a spinal catheter.
  • You recently underwent a spinal tap or had spinal anesthesia.
  • You take aspirin, other NSAIDs like ibuprofen (Advil, Motrin), naproxen (Aleve), diclofenac, indomethacin, meloxicam, or similar drugs.
  • You use other medicines to treat or prevent blood clots.
• Using Apixaban during pregnancy may increase bleeding risk during delivery. Inform your doctor if you are expecting or plan to conceive soon.
• Do not breastfeed while taking Apixaban.

Contraindications

• Active Pathological Bleeding: Do not use Apixaban in patients with ongoing pathological bleeding.
• Severe Hypersensitivity Reaction to Apixaban: Avoid using Apixaban in individuals who have experienced severe allergic reactions (such as, anaphylaxis) to the medication.

Missed Dose 

• Avoid missing doses of your anticoagulant to reduce the risk of clotting.
• If it’s closer to the time of your missed dose, take it as soon as possible.
• If it’s closer to the time of your next scheduled dose, skip the missed dose and proceed with the next one as planned.

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

Overdose

If you experience symptoms such as a skin rash or severe allergic reaction (including chest pain, swollen face or tongue, difficulty breathing, dizziness, or fainting), seek immediate medical assistance.

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

Storage 

• Keep the medicine in an air-tight container at room temperature, protected from heat, dampness, and direct light.
• Do not freeze.
• Keep out of the reach of children.
• Do not keep outdated medicine or medicine no longer needed.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Apixaban Interactions

• Blood Thinners and Anticoagulants: Using Apixaban with other blood thinners or anticoagulants (like, warfarin, heparin) can increase the risk of bleeding.
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Medications like ibuprofen, naproxen, and aspirin can increase the chances of bleeding when taken with Apixaban.
• Antiplatelet Drugs: Medications like clopidogrel can increase the risk of bleeding when used with Apixaban.
• Certain Antidepressants: Some antidepressants, like selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), can increase the risk of bleeding.
• Antifungal Medications: Drugs like ketoconazole and itraconazole can increase the levels of Apixaban in the blood, resulting in a higher risk of bleeding.
• HIV Protease Inhibitors: Medications like ritonavir can also increase the levels of Apixaban in the blood.
• Rifampin: This antibiotic can decrease the effectiveness of Apixaban by reducing its levels in the blood.

[Note: This isn’t a complete list, and there could be other drugs that interact with Apixaban. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

Apixaban Alternatives

• Rivaroxaban (rivaroxaban)
• Dabigatran (dabigatran etexilate)
• Edoxaban (edoxaban)
• Warfarin (warfarin sodium)
• Heparin (heparin sodium)
• Enoxaparin (enoxaparin sodium)
• Fondaparinux (fondaparinux sodium)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Quick Tips

1. 5 Foods to Avoid While on Eliquis in 2024: Eat This Instead
2. What Are the Side Effects of Eliquis and How to Manage Them?

Frequently Asked Questions

1. Do I need to discontinue Apixaban prior to surgery?

Due to bleeding risks, your Apixaban dosage may need adjustment or temporary discontinuation before surgery. Inform your surgeon and any healthcare professionals involved in your care, including your anticoagulant specialist, that you are on Apixaban. Show them your anticoagulant alert card to ensure they can make necessary adjustments to your medication regimen.

2. What are the consequences of discontinuing Apixaban?

It’s crucial not to halt Apixaban without consulting your doctor. Ceasing Apixaban can lead to your blood clotting rate reverting to its pre-medication state within a day or two. As a result, your risk of severe conditions like stroke, heart attack, deep vein thrombosis (DVT), or pulmonary embolism (PE) may elevate.

3. What needs to be checked regularly while on Apixaban?

Monitoring for signs of bleeding and bruising is essential when taking Apixaban. Your healthcare provider will closely supervise your condition to ensure your safety and well-being during asthma treatment.

4. What is the purpose of Apixaban 5 mg?

Apixaban 5 mg is utilized to prevent strokes or blood clots in individuals with atrial fibrillation (a condition characterized by irregular heartbeats, which elevates the risk of clots forming in the body and potentially leading to strokes), specifically when it is not related to heart valve disease.

5. Is Apixaban a preferred treatment for atrial fibrillation (AFib)?

Direct oral anticoagulants (DOACs), including Apixaban, are typically the preferred treatment options for preventing strokes in individuals with AFib not associated with heart valve issues. Apixaban may have a reduced risk of bleeding compared to other DOACs. Discuss with your healthcare provider for more information about your medication choices for AFib.

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